rapidly.2 This makes it unlikely that increased local blood flow will result in increased tissue concentrations in the steady state, though there is the possibility of an effect where frequent intravenous injections result in rapidly rising plasma levels. In 1987 our patient had three intravenous injections of phenytoin, two of 200 mg and one of 300 mg, but not before or since. While acute ischaemia can cause hyperperfusion,' this usually persists longer than the four days between the original SPECT scans.
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Sudo et al. (1990) studied this question.
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